Postpartum Depression Screening Scale: development and psychometric testing

BACKGROUND: Approximately 400,000 mothers in the United States experience postpartum depression each year. However, only a small proportion of these women are identified as depressed by health care professionals. OBJECTIVES: To improve detection of this postpartum mood disorder, the purpose of this study was to assess the psychometric properties of a newly devised instrument, the Postpartum Depression Screening Scale (PDSS), a 35-item Likert-type self-report instrument. METHODS: Content validity was supported through the literature and the judgments rendered by a panel of five content experts and a focus group. The PDSS was administered to 525 new mothers. RESULTS: Confirmatory factor analysis provided empirical support for the existence of the hypothesized seven dimensions. A Tucker-Lewis goodness-of-fit index of 0.87 and a root mean square residual of 0.05 were judged supportive of model fit. Item response theory techniques provided further construct validity support for finer interpretations of the respective seven dimensions. Analysis of the Likert 5-point response categories further supported meaningful score interpretations. Alpha internal consistency reliabilities ranged from 0.83 (sleeping/eating disturbances) to 0.94 (loss of self). CONCLUSIONS: Empirically, all of the reliability and validity analyses supported the score interpretations posited for the PDSS. Currently, the sensitivity, specificity, and positive predictive value of the PDSS are being determined.     

The Spanish version of the Prenatal Breast-feeding Self-efficacy Scale: Reliability and validity assessment

Background

Only a minority of infants are exclusively breastfed for the recommended 6 months postpartum. Breast-feeding self-efficacy is a mother's confidence in her ability to breastfeed and is predictive of breastfeeding behaviors. The Prenatal Breast-feeding Self-efficacy Scale (PBSES) was developed among English-speaking mothers to measure breastfeeding self-efficacy before delivery.

Objectives

To translate the PBSES into Spanish and assess its psychometric properties.

Design

Reliability and validity assessment.

Setting

A public hospital in Yecla, Spain.

Participants

A convenience sample of 234 pregnant women in their third trimester of pregnancy.

Methods

The PBSES was translated into Spanish using forward and back translation. A battery of self-administered questionnaires was completed by participants, including a questionnaire on sociodemographic variables, breastfeeding experience and intention, as well as the Spanish version of the PBSES. Also, data on exclusive breastfeeding at discharge were collected from hospital database. Dimensional structure, internal consistency and construct validity of the Spanish version of PBSES were assessed.

Results

Confirmatory factor analysis suggested the presence of one construct, self-efficacy, with four dimensions or latent variables. Cronbach's alpha coefficient for internal consistency was 0.91. Response patterns based on decision to breastfeed during pregnancy provided evidence of construct validity. In addition, the scores of the Spanish version of the PBSES significantly predicted exclusive breastfeeding at discharge.

Conclusions

The Spanish version of PBSES shows evidences of reliability, and contrasting group and predictive validity. Confirmatory factor analysis indicated marginal fit and further studies are needed to provide new evidence on the structure of the scale. The Spanish version of the PBSES can be considered a reliable measure and shows validity evidences.     

Some empirical evidence regarding the validity of the Spanish version of the McGill Pain Questionnaire (MPQ-SV)

Despite the fact that the McGill Pain Questionnaire (MPQ) is a useful pain assessment tool with widespread acceptance, empirical analyses have questioned its validity because they have not consistently supported the three a priori factors that guided its construction. The Spanish version that has followed the most systematic and rigorous reconstruction process (Lázaro C, Bosch F, Torrubia R, Banos JE. The development of a Spanish Questionnaire for assessing pain: preliminary data concerning reliability and validity. Eur J Psychol Assess, 1994;10:145-151) lacks evidence to support its construct validity. In the present study, the internal structure of the Spanish version of the McGill Pain Questionnaire (Lázaro C, Bosch F, Torrubia R, Banos JE. The development of a Spanish Questionnaire for assessing pain: preliminary data concerning reliability and validity. Eur J Psychol Assess, 1994;10:145-151) was examined in a sample of 202 acute pain patients and 207 chronic pain patients. Confirmatory factor analyses were carried out to compare alternative models postulating different internal structures (one-factor model, the classic three-factor model, and the semantic model inspired by the alternative structure found by Donaldson in 1995 (Donaldson GW. The factorial structure and stability of the McGill Pain Questionnaire in patients experiencing oral mucositis following bone marrow transplantation. Pain 1995;62:101-109)). Results from the LISREL CFA analysis indicated that the semantic model fitted better than the other models. On the other hand, intercorrelations between scales were smaller than the reliability indexes. In relation to concurrent evidence, significant correlations (0.001) were found between each subscale and the criteria measurements of every pain dimension. Only the affective subscale presented discriminant validity. Evidence supports the validity of the affective and sensory subscales but not the evaluative scale.     

Methods to document semantic equivalence of a translated scale

To ensure the semantic equivalence of the Postpartum Depression Screening Scale (PDSS)-Spanish Version, multiple methods were used, including back-translation, the committee approach, pretest techniques, and alternate forms equivalence. The back-translation process involved eight translators who represented the four predominant Hispanic groups in the United States. In the committee approach the Hispanic translators convened together to discuss the results of the back-translations and to come to group consensus on problematic items. In pretesting the PDSS-Spanish Version was field-tested with five Hispanic mothers, and it was determined that it accurately captured the connotative meanings of the screening scale. Alternate forms equivalence of the two language versions of the PDSS was assessed with a sample of 30 bilingual Hispanic mothers. Alpha reliability estimates ranged from 0.94 to 0.99. Though lengthy, this systematic procedure was needed to guarantee the production of a fully equivalent linguistic version of the PDSS.     

The measurement of disability-related stress in wheelchair users

OBJECTIVE: To measure disability-related stress through the development of the Physical Disability Stress Scale (PDSS) for wheelchair users. DESIGN: Cross-sectional. SETTING: General community. PARTICIPANTS: Sample of 119 wheelchair users with an acquired physical disability. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: General Health Questionnaire-28 (GHQ) and the World Health Organization Quality of Life (WHOQOL-BREF) (Australian version). RESULTS: Factor analysis of PDSS items revealed 4 main factors of disability-related stress: access accounted for 33.7% of the variance, physical for 8.4% of the variance, social for 7.9% of the variance, and burden of care for 7.2% of the variance. Internal consistencies for the 4 factors were within acceptable ranges (alpha range, .78-.83). Concurrent validity was shown with the PDSS factors predicting 7% to 23% of the variance in GHQ subscales and total score and 12% to 31% of the WHOQOL-BREF subscales. Participants scoring in the GHQ psychiatric group showed significantly higher stress levels on the physical, social, and burden of care factors of the PDSS compared with the GHQ nonpsychiatric group. CONCLUSIONS: The results suggest the PDSS factors are valid measures of disability-related stress with potential for clinical and research applications. Confirmatory factor analyses with larger sample sizes of wheelchair users are required to establish consistency in the measurement of disability-related stress.     

The Activities-specific Balance Confidence scale: reliability and validity in Spanish patients with vestibular disorders

Purpose: To examine the reliability and validity of the Spanish version of the Activities-specific Balance Confidence scale (ABC-S), and its ability to discriminate between patients with and without a history of falls among a Spanish population with vestibular disorders. Method: A total of 84 participants completed the ABC-S. Internal consistency, test–retest reliability and construct validity (exploratory factor analysis) were analysed. Concurrent validity was evaluated using the 12-item Short Form Health Survey (SF-12) and the Dizziness Handicap Inventory (DHI). To determine the accuracy of the ABC total score in discriminating patients with and without a history of falls, a receiver operating characteristic (ROC) curve analysis was performed. Results: The ABC-S showed excellent internal consistency (Cronbach’s α?=?0.916) and substantial test–retest reliability (ICC?=?0.86, 95% CI: 0.74–0.93), with standard error and minimal detectable change values of 8.64 and 16.94, respectively. Factor analyses suggested a three-factor structure (explained variance was 62.24%). The ABC total score significantly correlated with the physical component summary score of the SF-12 and with the DHI-P, DHI-E, DHI-F and DHI total scores (p?p?Conclusions: The ABC-S is a valid and reliable instrument, suitable to assess balance confidence in Spanish patients with vestibular disorders.

• Implications for Rehabilitation

• The Spanish version of the ABC scale is a valid and reliable measure of balance confidence in patients with vestibular disorders.

• In persons with vestibular disorders, the Spanish version of the ABC scale has shown the ability to discriminate between patients with and without a history of falls in the last year.

     

Validity and Reliability of the FIM Instrument in the Inpatient Burn Rehabilitation Population

Objective

To provide evidence of construct validity for the FIM instrument in the inpatient rehabilitation burn population.

Design

Confirmatory factor analysis and item response theory were used to assess construct validity. Confirmatory factor analysis was performed on a 2-factor model of the FIM instrument and on a 6-subfactor model. Mokken scale analysis, a nonparametric item response theory, was performed on each of the FIM instrument's 2 major factors, motor and cognitive domains. Internal consistency using Cronbach alpha and Molenaar and Sijtsma's statistic was also examined.

Setting

Inpatient rehabilitation facilities.

Participants

Data from the Uniform Data System for Medical Rehabilitation for patients with an impairment code of burn injury from the years 2002 to 2011 were used for this analysis. A total of 7569 subjects were included in the study.

Interventions

Not applicable.

Main Outcome Measures

Comparative fit index results for the confirmatory factor analyses and adherence to assumptions of the Mokken scale model.

Results

Confirmatory factor analysis provided a comparative fit index of .862 for the 2-factor model and .941 for the 6-subfactor model. Mokken scale analysis showed scalability coefficients of .681 and .891 for the motor and cognitive domains, respectively. Measures of internal consistency statistic gave values of >.95 for each major domain of the FIM instrument.

Conclusions

The FIM instrument has evidence of validity and reliability as an outcome measure for patients with burn injuries in the inpatient rehabilitation setting. The 6-subfactor model provides a better fit than the 2-factor model by confirmatory factor analysis. There is evidence that the motor and cognitive domains each form valid unidimensional metrics based on nonparametric item response theory.     

Validation of an intensity of interprofessional collaboration questionnaire translated into Spanish

ObjectiveTo assess the validity and reliability of the Spanish version of the Intensity of Interprofessional Collaboration questionnaire (Sicotte et al).MethodsIn the first phase, the questionnaire was translated and adapted to Spanish. The questionnaire was then distributed to a sample of 123 nurses in a Spanish University hospital. In the second phase, the construct validity, convergent validity, and internal consistency of the Spanish version of the questionnaire were determined.ResultsA principal components analysis with Promax rotation suggested the existence of 4 factors that accounted for 61.47% of the total variance. Pearson's correlation coefficient between the Spanish instrument and another instrument measuring the same phenomenon was 0.71. Analysis of the internal consistency of the instrument showed a Cronbach's α coefficient of 0.90.ConclusionsWe can conclude that the intensity of interprofessional collaboration scale shows good validity and reliability in the measurement of the intensity of collaboration among professionals in healthcare teams.     

护士进修动机量表编制与信效度分析

目的编制有良好信效度的护士进修动机量表,为进一步研究护士进修动机提供可靠测量工具。方法以国内外相关研究理论为基础,经专家咨询法、探索性因子分析形成护士进修动机量表,并对量表的重测信度、内部一致性、结构效度进行检验。结果编制5因子22条目护士进修动机量表,各因子和整体量表的克朗巴哈α系数均在0.8以上,具有良好的内部一致性;各因子得分和量表总分两次测试的相关系数均在0.7以上,重测信度较好;验证性因子分析显示问卷的结构效度拟合良好。结论本次编制的护士进修动机量表具有较高的信度与效度。     

Psychometric evaluation of Breast Health Behavior Questionnaire: Spanish version

The purpose of the study was to test the psychometric properties of a culturally sensitive and theory-based instrument: the Breast Health Behavior Questionnaire. This instrument was translated into Spanish and back-translated at a third- to fourth-grade reading level. The pilot group consisted of 70 Hispanic women who attended a class at a local church. Subsequent to pilot testing, another 40 Hispanic women who attended a class at the local health department comprised the study sample. The participants responded to the 15-item questionnaire, which is formatted as a Likert scale. Content validity of the Breast Health Behavior Questionnaire was determined by a panel of experts. A factor analysis of this instrument showed five separate dimensions accounting for 71.82% of the instrument's variance. The three major components of self-regulation theory (schema, coping, and appraisal criteria) were found clustered within the first three dimensions after three items were discarded. The Breast Health Behavior Questionnaire demonstrated an internal consistency reliability coefficient of .7172. The psychometric properties of the Spanish version of this questionnaire warrant further research. The instrument may support a better understanding of the Hispanic woman's practice of breast health behavior. Eventually, the Breast Health Behavior Questionnaire may assist nurses in the formulation of culturally grounded interventions.     

Psychometric testing of the Chinese version of the medical outcomes study social support survey (MOS-SSS-C)

The purpose of this study was to assess the psychometric properties of the Chinese version of the Medical Outcomes Study Social Support Survey (MOS-SSS-C) in a sample of 110 patients. Criterion-related and construct validities of the MOS-SSS-C were evaluated by correlations with the Chinese version of the Multidimensional Perceived Social Support Survey (r =.82) and the Hospital Anxiety and Depression Scale (r = -.58). Confirmatory factor analysis affirmed the four-factor structure of the MOS-SSS-C in measuring the functional aspects of perceived social support. Cronbach's alphas for the subscales ranged from.93 to.96, whereas the alpha for the overall scale was.98. The 2-week test-retest reliability of the MOS-SSS-C as measured by the intraclass correlation coefficient was.84. The MOS-SSS-C is a psychometrically sound multidimensional measure for the evaluation of functional aspects of perceived social support by Chinese patients with chronic disease.     

Further validation of the Postpartum Depression Screening Scale

BACKGROUND: Up to 50% of all cases of postpartum depression go undetected. The Edinburgh Postnatal Depression Scale (EPDS) has been the only instrument available that was specifically designed to screen for this mood disorder. None of the items on the EPDS, however, are written in the context of new motherhood. OBJECTIVE: The purpose of this study was to further assess the construct validity of the newly designed Postpartum Depression Screening Scale (PDSS) along with its sensitivity, specificity, and predictive values. METHOD: A total sample of 150 mothers within 12 weeks postpartum participated in the study. Each mother completed in random order three questionnaires: The PDSS, EPDS, and The Beck Depression Inventory-II (BDI-II). Immediately after completing these three questionnaires, each woman was interviewed by a nurse psychotherapist using the Structural Clinical Interview for DSM-IV Axis 1 Disorders. RESULTS: Twelve percent (n = 18) of the mothers were diagnosed with major postpartum depression, 19% (n = 28) with minor postpartum depression, and 69% (n = 104) with no depression. The PDSS was strongly correlated with both the BDI-II (r = 0.81) and the EPDS (r = 0.79). The ability of the PDSS to explain variance in diagnostic classification of postpartum depression above that explained by the BDI-II and EPDS (i.e., incremental validity) was assessed using hierarchical regression. After explaining variance in group classification by the other two depression instruments, the PDSS explained an additional 9% of the variance in depression diagnosis. Using receiver operating characteristic (ROC) curves, a PDSS cut-off score of 80 (sensitivity 94% and specificity 98%) is recommended for major postpartum depression and a cut-off score of 60 (sensitivity 91% and specificity 72%) for major or minor depression. CONCLUSION: Based on the results of this psychometric testing, the PDSS is considered ready for use in routine screening of mothers.     

Comparative analysis of the performance of the Postpartum Depression Screening Scale with two other depression instruments

BACKGROUND: Postpartum depression affects approximately 13% of mothers but up to 50% of all cases of this tragic illness can go undetected. OBJECTIVE: The purpose of this study was to compare the performance of a newly created instrument, the Postpartum Depression Screening Scale (PDSS), with the Edinburgh Postnatal Depression Scale (EPDS) and a general depression scale, the Beck Depression Inventory-II (BDI-II). METHOD: In this methodological design a total of 150 new mothers completed these three instruments in random order, followed immediately by a DSM-IV diagnostic interview. Using the LABROC I program, the areas under each of the instrument's Receiver Operator Characteristic (ROC) curves were compared to determine if they were significantly different. RESULTS: Eighteen (12%) of the women were diagnosed with major postpartum depression, 28 women (19%) with minor postpartum depression, and 104 women (69%) with no depression. Compared to the EPDS, the PDSS had a significantly larger area under the ROC curve when screening for major or minor postpartum depression. When using the published recommended cut-off scores for major depression for the three instruments, the PDSS achieved the highest combination of sensitivity, 94%, and specificity, 98%. When detecting women with major or minor postpartum depression, the PDSS again yielded the highest combination of sensitivity (91%) and specificity (72%) of the three instruments. The PDSS identified 17 (94%) of the women diagnosed with major postpartum depression, the EPDS identified 14 of these women (78%), and the BDI-II identified 10 of the 18 women (56%). CONCLUSION: If mothers identified as "most depressed" are substantially determined by the instrument used, the implications for both research and clinical practice are significant. Researchers and clinicians need to be aware of the differential sensitivity of depression instruments which, while supposedly measuring the same construct, are focused on different components of this mood disorder.     

Quality of paediatric rehabilitation from the parent perspective: validation of the short Measure of Processes of Care (MPOC-20) in the Netherlands

OBJECTIVE: In the present study we aim to assess the reliability and validity of the 20-item version of the Dutch Measure of Processes of Care (MPOC). DESIGN: The reliability, concurrent validity, predictive validity and construct validity of the Dutch MPOC-20 were determined. A subset of MPOC-20 data was extracted from a large Dutch MPOC (56-item version) database. SUBJECTS: Participants were 405 mothers and 22 fathers of children aged 1-18 years recruited through nine paediatric rehabilitation centres in the Netherlands. MAIN MEASURES: The participants filled out the MPOC-20 items, the Client Satisfaction Questionnaire (CSQ), and two additional questions about satisfaction with services and the amount of stress they experienced. RESULTS: The internal consistency analyses (alphas 0.75-0.87) and the test-retest analyses (intraclass correlation coefficients (ICCs) 0.78-0.91) showed that the Dutch MPOC-20 is a reliable tool. The concurrent validity of the Dutch MPOC-20 was confirmed by positive correlations between MPOC-20 scale scores and the CSQ (r 0.39-0.69), and between MPOC-20 scale scores and an overall satisfaction variable (r 0.37-0.66). The predictive validity of the Dutch MPOC-20 was supported by moderately negative correlations between MPOC-20 scores and a stress variable (r -0.27 to -0.44). The construct validity of the Dutch MPOC-20 was confirmed by significant scale intercorrelations (r 0.41-0.84) and a factor analysis. CONCLUSIONS: The 20-item version of the MPOC (Dutch MPOC-20) is a reliable and valid measure of the family-centredness of paediatric rehabilitation.     

Validity and reliability of the Japanese version of the European Heart Failure Self-Care Behavior Scale

BACKGROUND: It is important to assess the self-care behavior of patients with heart failure. However, in Japan, there is no valid and reliable scale for this purpose. The European Heart Failure Self-Care Behavior Scale (EHFScBS) is used to measure the self-care behavior of heart failure patients. The purpose of this study was to translate the EHFScBS into Japanese and evaluate its validity and reliability. METHODS AND RESULTS: A convenience sample of 116 outpatients with heart failure completed the Japanese version of the EHFScBS. Confirmatory factor analysis demonstrated the one-dimensionality of the scale. The Japanese version of the EHFScBS was significantly correlated with another scale, which was considered to evaluate the concept linked with the self-care behavior theoretically. These confirm its construct validity. Cronbach's alpha was 0.71, suggesting that internal consistency was satisfactory. Test-retest reliability was evaluated. The intraclass correlation coefficient of the scale was 0.69 and weighted kappa for individual items was 0.33-0.87, suggesting that test-retest reliability is adequate. CONCLUSIONS: The Japanese version of the EHFScBS was showed acceptable validity and reliability. It can be used to evaluate self-care behavior of Japanese patients with heart failure.     

母乳喂养动机量表的汉化及信效度检验

目的 对母乳喂养动机量表（Breastfeeding Motivation Scale,BMS）进行汉化并检验其信效度。 方法 按照Brislin的翻译模型对原量表进行直译与回译,经过文化调适及预测试后,确定中文版BMS。于2020年12月—2021年5月,采取便利抽样法选取南京市某三级甲等医院的312名初产妇进行问卷调查,评价量表的信效度;于2021年6月—10月,采取便利抽样法选取270名初产妇发放问卷,进行验证性因子分析。 结果 中文版BMS共4个维度、24个条目,分别为享受（8个条目）、联结和母亲自我认知（8个条目）、重要的他人压力（4个条目）、实用性需求（4个条目）。中文版BMS条目水平的内容效度指数为0.830~1.000,量表水平的内容效度指数为0.901。各维度的Cronbach’s α系数为0.709~0.934,分半信度为0.717~0.930;验证性因子分析结果显示,模型适配度良好。 结论 中文版BMS具有良好的信效度,可用于对母乳喂养动机进行评估,提升母乳喂养积极心理。     

简版脑卒中患者专门生存质量量表的汉化及信度、效度检验

目的 开发建立适用于我国脑卒中康复期患者生存质量评估的中文版量表.方法 在POST教授的简版脑卒中患者专门生存质量量表(the short version of the stroke specific quality of life scale,SV-SS-QoL)的基础上,采用双人翻译-回译的方法对英文版SV-SS-...     

中文修订版疾病不确定感父母量表的信效度检验

目的：评价中文修订版Mishel疾病不确定感父母量表（Parent＇s Perception Uncertainty Scale,PPUS）信效度。方法：翻译并形成中文版PPUS,采用方便抽样抽取202例白血病患儿父母,运用SPSS17．0和AMOS17．0进行统计分析其信效度。结果：中文修订版PPUS总的Cronbacha系数为0．929及四个维度的Cronbaehn系数为0．602一0．897,分半信度为0．868,各分量表与总分的相关系数为0．499-0．934,分量表间的相关系数为0．499—0．752。经过两次探索性因素分析产生的4个因子共能解释总变异的59．023％。验证性因素四因子模型拟合良好。结论：中文版修订版PPUS量表有较好的信度和效度,作为测量国内患儿父母疾病不确定感的工具是可信和有效的。     

Screening performance of the postpartum depression screening scale--Spanish version.

The purpose Puerto Rican/Caribbean (n = 68), Mexican (n = 64), and Central/South American (n = 18). For the three subgroups, the PDSS total score alpha reliabilities were .96, .95, and .95, respectively. Based on the receiver operating characteristic (ROC) curve analysis, a cutoff score of 60 is recommended as a positive screen for combined major and minor depression. This cutoff point obtained a sensitivity of 84% and specificity of 84%. When compared to the original English version of the PDSS, the psychometrics for the Spanish version were slightly lower but well within the acceptable range.     

Psychometric evaluation of the Spanish and English versions of the spiritual coping strategies scale

The Spiritual Coping Strategies (SCS) Scale measures how frequently religious and nonreligious (spiritual) coping strategies are used to cope with a stressful experience. This study's purpose is to evaluate the psychometric properties of the newly translated Spanish version of the SCS. A total of 51 bilingual adults completed the SCS in Spanish and English, with 25 completing them again 2-3 weeks later. Internal consistency reliability for the Spanish (r = 0.83) and English (r = 0.82) versions of the SCS in the total sample were good. Test-retest reliability was .84 for the Spanish and .80 for the English version. Spanish and English responses to the SCS items and the resulting score for the subscales and the total scale were not significantly different. Scores on the English and Spanish versions were correlated as expected with time since the stressful event and happiness with family and with spouse or partner, supporting the validity of the Spanish SCS. Study findings support the reliability and validity of the newly translated Spanish SCS.